Question

Can hepatitis B reactivate?

29 December 2009. Related: All topics, CD4 and viral load, HIV transmission, Opportunistic infections.

My partner started HAART for his HIV 2 1/2 years ago, he also had hepB several years ago in which HepB DNA was still detected (low level) in his bloods in Feb 2007. He since has taken HIV medication (selected to also eradicate HepB) which has increased his CD4 count from 33 to 290, his viral load from 370,000 down to less than 40 copies/mL and up to June 2009 his HepB DNA was undetectable.

However blood tests in June 2009 found that his HepB DNA was evident in his bloods again. It seems very unlikely that his original HepB has reactivated itself, but I’m not sure what bearing his HIV will have on this and whether this is common in HIV patients. He has just had another PCR assay done (Sep 2009) and it seems that he is still positive for HepB.

I am now seriously wondering if he has been unfaithful. I know a long time ago he used prostitutes so this is really worrying me and I would really like to know how this may be possible.

He also has HepC and I am negative for HIV, HepB and HepC.

Thank You

Answer

Answer: Simon Collins

Hi

Some people who are not able to clear hepatitis B become carriers, and their hepB infection can flare up again in the future.

This can even occur if they are taking treatments for both HIV and hepB and may be related to other liver problems that his doctor should check for.

These test results do not indicate anything about whether your partner has slept with anyone else.

If you are worried about this aspect of your relationship, perhaps speak to your partner, or a healthcare worker or health advisor.

If you are using condoms everytime that you have penetrative sex, this will protect you from HIV and hepC. For your own health you should have a vaccination to protect you from hepatitis B. This is free in the UK on the NHS.